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Implant Placement: How Long Do I Wait After Extraction?

Question:

Charles asks:

I am still confused by everything I am reading and being told by dentists. Can someone clarify this issue for me: How long should I wait after an extraction to have the implant placed, 6 months, 12 months? Can it be done immediately, as I'm being told by some dentists? What is the standard right now?

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Hi Charles,
There is no "one" standard answer to this question. It depends on the exact situation in regards to the existing condition of the tooth that is going to be extracted. Implant placement can be anywhere from immediate to several months later depending on many factors. The best way to find out is to discuss your individual situation carefully with your treating dentist.

Hello Charles
The answer to when an implant can be placed will depend upon:
1) Is the extraction site infected from the abscessed
or periodontally envolved tooth? Was the tooth
removed for endodontia reasons? (These sites show a
higher failure rate). More time is required to resolve
the infection.
2) How large is the surgical defect? Some sites will
require grafting to establish proper volume and
contour of the intended implant site.
3) Can an implant larger than the "clean" extraction
site be immediately placed?
4) What are the surface characteristics of the
selected implant? Some implants allow faster
integration.
5) The practicioner you select will carefully review
the treatment plan with you.

Charles:
Here is some information that may help you clear things up:
The bone where the implant needs to be placed always resorbs (shrinks) after the tooth is removed, and the greatest resorption occurs the first six months after an extraction.
The only thing that will keep your bone from disappearing is the roots of a natural tooth, an implant, or grafting the socket immediately after the tooth is extracted.
It is well documented in the literature that placing the implant immediately after the extraction has the best chance of maintaining the tissues as close to ideal as possible.
If you have to have an extraction in the smile zone and cosmetics is important, immediate placement is preferred.
If you choose delayed placement of the implant (sometimes done when there is an active infection) then make sure you graft the socket to preserve as much bone as possible.
Good luck.